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NURS 572 Ch 56
Pharm Diabetes Mellitus 2 of 2
Question | Answer |
---|---|
What insulin can be given IV as well as SQ | regular insulin is the only one |
how are lispro, aspart and glargine admin | these only given SQ |
what insulins can be given SQ | ALL insulins can be given SQ |
why do we gently roll NPH and all mixes before admin | roll, not shaken to preserve protamine's duration of action |
what is the major side affect of all insulins | hyperinsulinemia --> hypoglycemia |
other SEs of insulin | lipidystrophy at injection site (rotate), localized allergic reaction due to adjunct. true insulin allergy is rare |
what are the drugs that can cause hypoglycemia | sulfonylureas, meglitinides, insulin, amylin mimetics, incretin mimetics and gliptin DPP4inhibitors |
injectible amylin mimetic that can't be combined | pramlintide |
name 2 injectible incretin mimetics | exenatide (BID) liraglutide (QD) |
MOA of pramlintide | amylin mimetic: B-cells secretagogue, increase satiety. post prandial glucose regulation type1 type2 |
MOA of exenatide, liraglutide | incretin mimetic: intestinal cells secretagogue, decrease glucagon, increase satiety. post prandial glucose regulation type 2 not controlled by oral meds. |
what are SEs of amylin & incretin mimetics | Compliance SEs are n/v/a. also hypoglycemia, HA |
DPP4 inhibitor-gliptins admin how, with what curious SEs | these are oral drugs. SEs nasopharyngitis, URI, HA and immune effects possible. |
MOA of gliptins -DPP4 inhibitors | they potentiate the action of incretins by deactivating their DPP4 enzyme. same net effect to increase insulin, decrease glucagon and increase satiety |
name 3 gliptin DPP4 inhibitors | sita, saxa & lina gliptin |
can we use oral antidiabetic drugs in pregnant or lactating women | no, No, NO they are contraindicated |
MOA of sulfonylureas and meglitinides | secretagogue to increase insulin secretion from Beta cells. |
SEs of sulfonylureas and meglitinides | hyperinsulinemia-->hypoglycemia, risk of weight gain |
name 3 sulfonylureas | glipizide, glyburide, glimepriride |
which sulfonylurea is safest in elderly or those with renal impairment | glipizide bwo inactive metabolites |
glyburide class | sulfonylurea |
which sulfonylurea has potential for water retention | glimepirde |
name 2 meglitinides | repaglinide, nateglinide |
MAJOR SE of meglitinides | hypoglycemia major SE |
class of repaglinide | meglitinide class |
class of nateglinide | meglitinide class |
how are sulfonylureas and meglitinides administered | these classes are oral admin |
what 2 drug classes have 2 functions (decrease glycogenolysis, increase sensitivity peripheral receptors) | biguadide/metformin and glitazones have these actions |
what is primary/secondary MOA of biguadide/metformin | primary = decrease glycogenolysis secondary = increase sensitivity peripheral receptors |
what is primary/secondary MOA of glitazones | primary = increase receptor sensitivity secondary = decreased glycogenolysis |
which drug has ADR of lactic acidosis | metformin has this ADR, along with a/n/v/d |
which drug is contraindiated for patients with renal, liver, hypoxic or perfusion diseases, or any condition that may invoke glycolysis anerobic metabolism | metformin is contraindiated for these patients |
which drug class has ADR of hepatotoxicity | glitazones have this ADR |
Name 2 glitazones | pio-glitazone, rosi-glitazone |
which glitazone has long acting metabolite | pio-glitazone |
which glitazone may possibly increase CV deaths | rosi-glitazone |
sitagliptin QD class | DPP4 inhibitor - gliptin |
saxagliptid QD class | DPP4 inhibitor - gliptin |
lingagliptin QD class | DPP4 inhibitor - gliptin |
MOA alpha-glucosidase inhibitors | take at meal so enzyme that metabolizes carbs is inactivated |
what are ADRs of alpha-glucosidase inhibitors | wicked flatulence, cramps, distention |
name 2 oral alpha-glucosidase inhibitors | acarbose, miglitol |
acarbose class | alpha glucosidase inhibitor |
miglitol class | alpha glucosidase inhibitor |